DASS 21

DEPRESSION ANXIETY STRESS SCALE (DASS 21) Patient Instructions: Rate each question 0, 1, 2 or 3, indicating how much the statement applied to you over the past week. There are no right or wrong answers. Do not spend too much time on any statement. Rating scale: 0 = Did not apply to me at all - NEVER 1 = Applied to me to some degree, or some of the time - SOMETIMES 2 = Applied to me to a considerable degree, or a good part of time - OFTEN 3 = Applied to me very much, or most of the time - ALMOST ALWAYS Depression scale: 0 : I couldn’t seem to experience any positive feeling at all. 0 : I found it difficult to work up the initiative to do things. 0 : I felt that I had nothing to look forward to. 0 : I felt down-hearted and blue. 0 : I was unable to become enthusiastic about anything. 0 : I felt I wasn’t worth much as a person. 0 : I felt that life was meaningless. Score: 0-4 = normal, 5-6 = mild, 7-10 = moderate, 11-13 = severe, 14+ = extremely severe. Anxiety scale: 0 : I was aware of dryness of my mouth. 0 : I experienced breathing difficulty (eg, excessively rapid breathing, breathlessness in the absence of physical exertion). 0 : I experienced trembling (eg, in the hands). 0 : I was worried about situations in which I might panic and make a fool of myself. 0 : I felt I was close to panic. 0 : I was aware of the action of my heart in the absence of physical exertion (eg, sense of heart rate increase, heart missing a beat). 0 : I felt scared without any good reason. Score: 0-3 = normal, 4-5 = mild, 6-7 = moderate, 8-9 = severe, 10+ = extremely severe. Stress scale: 0 : I found it hard to wind down. 0 : I tended to overreact to situations. 0 : I felt that I was using a lot of nervous energy. 0 : I found myself getting agitated. 0 : I found it difficult to relax. 0 : I was intolerant of anything that kept me from getting on with what I was doing. 0 : I felt that I was rather touchy. Score: 0-7 = normal, 8-9 = mild, 10-12 = moderate, 13-16 = severe, 17+ = extremely severe.

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Patient record sheet

[Depression Anxiety Stress Scale (DASS 21)] Patient: Date: Patient Instructions: - Rate each question 0, 1, 2 or 3, indicating how much the statement applied to you over the past week. - There are no right or wrong answers. Do not spend too much time on any statement. Rating scale: 0 = Did not apply to me at all - NEVER 1 = Applied to me to some degree, or some of the time - SOMETIMES 2 = Applied to me to a considerable degree, or a good part of time - OFTEN 3 = Applied to me very much, or most of the time - ALMOST ALWAYS Depression scale: ___ I couldn’t seem to experience any positive feeling at all. ___ I found it difficult to work up the initiative to do things. ___ I felt that I had nothing to look forward to. ___ I felt down-hearted and blue. ___ I was unable to become enthusiastic about anything. ___ I felt I wasn’t worth much as a person. ___ I felt that life was meaningless. Score: _____ Anxiety scale: ___ I was aware of dryness of my mouth. ___ I experienced breathing difficulty (eg, excessively rapid breathing, breathlessness in the absence of physical exertion). ___ I experienced trembling (eg, in the hands). ___ I was worried about situations in which I might panic and make a fool of myself. ___ I felt I was close to panic. ___ I was aware of the action of my heart in the absence of physical exertion (eg, sense of heart rate increase, heart missing a beat). ___ I felt scared without any good reason. Score: _____ Stress scale: ___ I found it hard to wind down. ___ I tended to overreact to situations. ___ I felt that I was using a lot of nervous energy. ___ I found myself getting agitated. ___ I found it difficult to relax. ___ I was intolerant of anything that kept me from getting on with what I was doing. ___ I felt that I was rather touchy. Score: _____

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Related items

• Kessler psychological distress scale (K10)
• PHQ-9 depression questionnaire